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The association between vitamin D and COPD risk, severity, and exacerbation: an updated systematic review and meta-analysis.
Int J Chron Obstruct Pulmon Dis 2016; 11:2597-2607IJ

Abstract

BACKGROUND

In recent years, the pleiotropic roles of vitamin D have been highlighted in various diseases. However, the association between serum vitamin D and COPD is not well studied. This updated systematic review and meta-analysis aimed to assess the relationship between vitamin D and the risk, severity, and exacerbation of COPD.

METHODS

A systematic literature search was conducted in PubMed, Medline, EMBASE, Chinese National Knowledge Infrastructure, Wanfang, and Weipu databases. The pooled risk estimates were standardized mean difference (SMD) with 95% confidence interval (CI) for vitamin D levels and odds ratio (OR) with 95% CI for vitamin D deficiency. Meta-regression and subgroup analyses were performed on latitude, body mass index, and assay method.

RESULTS

A total of 21 studies, including 4,818 COPD patients and 7,175 controls, were included. Meta-analysis showed that lower serum vitamin D levels were found in COPD patients than in controls (SMD: -0.69, 95% CI: -1.00, -0.38, P<0.001), especially in severe COPD (SMD: -0.87, 95% CI: -1.51, -0.22, P=0.001) and COPD exacerbation (SMD: -0.43, 95% CI: -0.70, -0.15, P=0.002). Vitamin D deficiency was associated with increased risk of COPD (OR: 1.77, 95% CI: 1.18, 2.64, P=0.006) and with COPD severity (OR: 2.83, 95% CI: 2.00, 4.00, P<0.001) but not with COPD exacerbation (OR: 1.17, 95% CI: 0.86, 1.59, P=0.326). Assay methods had significant influence on the heterogeneity of vitamin D deficiency and COPD risk.

CONCLUSION

Serum vitamin D levels were inversely associated with COPD risk, severity, and exacerbation. Vitamin D deficiency is associated with increased risk of COPD and severe COPD but not with COPD exacerbation. It is worth considering assay methods in the heterogeneity sources analysis of association between vitamin D deficiency and COPD.

Authors+Show Affiliations

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27799758

Citation

Zhu, Min, et al. "The Association Between Vitamin D and COPD Risk, Severity, and Exacerbation: an Updated Systematic Review and Meta-analysis." International Journal of Chronic Obstructive Pulmonary Disease, vol. 11, 2016, pp. 2597-2607.
Zhu M, Wang T, Wang C, et al. The association between vitamin D and COPD risk, severity, and exacerbation: an updated systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2016;11:2597-2607.
Zhu, M., Wang, T., Wang, C., & Ji, Y. (2016). The association between vitamin D and COPD risk, severity, and exacerbation: an updated systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 11, pp. 2597-2607.
Zhu M, et al. The Association Between Vitamin D and COPD Risk, Severity, and Exacerbation: an Updated Systematic Review and Meta-analysis. Int J Chron Obstruct Pulmon Dis. 2016;11:2597-2607. PubMed PMID: 27799758.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between vitamin D and COPD risk, severity, and exacerbation: an updated systematic review and meta-analysis. AU - Zhu,Min, AU - Wang,Ting, AU - Wang,Chengdi, AU - Ji,Yulin, Y1 - 2016/10/19/ PY - 2016/11/2/pubmed PY - 2017/8/10/medline PY - 2016/11/2/entrez KW - COPD KW - exacerbation KW - meta-analysis KW - risk KW - severity KW - vitamin D SP - 2597 EP - 2607 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 11 N2 - BACKGROUND: In recent years, the pleiotropic roles of vitamin D have been highlighted in various diseases. However, the association between serum vitamin D and COPD is not well studied. This updated systematic review and meta-analysis aimed to assess the relationship between vitamin D and the risk, severity, and exacerbation of COPD. METHODS: A systematic literature search was conducted in PubMed, Medline, EMBASE, Chinese National Knowledge Infrastructure, Wanfang, and Weipu databases. The pooled risk estimates were standardized mean difference (SMD) with 95% confidence interval (CI) for vitamin D levels and odds ratio (OR) with 95% CI for vitamin D deficiency. Meta-regression and subgroup analyses were performed on latitude, body mass index, and assay method. RESULTS: A total of 21 studies, including 4,818 COPD patients and 7,175 controls, were included. Meta-analysis showed that lower serum vitamin D levels were found in COPD patients than in controls (SMD: -0.69, 95% CI: -1.00, -0.38, P<0.001), especially in severe COPD (SMD: -0.87, 95% CI: -1.51, -0.22, P=0.001) and COPD exacerbation (SMD: -0.43, 95% CI: -0.70, -0.15, P=0.002). Vitamin D deficiency was associated with increased risk of COPD (OR: 1.77, 95% CI: 1.18, 2.64, P=0.006) and with COPD severity (OR: 2.83, 95% CI: 2.00, 4.00, P<0.001) but not with COPD exacerbation (OR: 1.17, 95% CI: 0.86, 1.59, P=0.326). Assay methods had significant influence on the heterogeneity of vitamin D deficiency and COPD risk. CONCLUSION: Serum vitamin D levels were inversely associated with COPD risk, severity, and exacerbation. Vitamin D deficiency is associated with increased risk of COPD and severe COPD but not with COPD exacerbation. It is worth considering assay methods in the heterogeneity sources analysis of association between vitamin D deficiency and COPD. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/27799758/The_association_between_vitamin_D_and_COPD_risk_severity_and_exacerbation:_an_updated_systematic_review_and_meta_analysis_ L2 - https://dx.doi.org/10.2147/COPD.S101382 DB - PRIME DP - Unbound Medicine ER -